Check the medical admissibility of a claim by confirming the diagnosis and treatment details.
- Scrutinize the claims, as per the terms and conditions of the insurance policy
- Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc.
- Understand the process difference between PA and an RI claim and verify the necessary details accordingly.
- Verify the required documents for processing claims and raise an IR in case of an insufficiency.
- Coordinate with the LCM team in case of higher billing and with the provider team in case of non
- availability of tariff.
- Approve or deny the claims as per the terms and conditions within the TAT.
- Handle escalations and responding to mails accordingly.

Pay: ₹350,000.00 - ₹400,000.00 per year

Perks:
- Health insurance
- Paid sick time
- Paid time off
- Provident Fund

Application Question(s):
- Do you have a degree in BHMS / BAMS ?
- What is your current CTC?
- How many years of experience do you have?

Work Location: In person

📌 Medical Officer (Mumbai)
🏢 MEDI ASSIST INSURANCE TPA PRIVATE
📍 Mumbai